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Health in rural and remote areas
Introduction
Rural health appeared as a major concern in 1990s when Australian government understood and analysed the status of rural health as evidence from mainstream health program. Taking into account the fact that health institutions are failed in meeting the health needs of people, it is asserted that about 7 million people in Australia are living in the areas outside major cities and this gap paves the way for depressed standards of living. People who are living in remote and regional areas have frequently reported about poor health risk profiles. A common example is, people living in rural areas are more prone to drink alcohol, smoke and be overweight. There is a decreased ratio of education, lower income and other factors that are associated with the circumstances of poor health. It is a common observation that rural population is less likely to have access to health facilities. Due to increasing road distances, people prefer self-medication over opting for better health services. It is significant to note if people ever dare to avail the services out there in cities, the conditions and circumstances are so worst that there is hardly any chance of positive retrieval. The most devastating fact is, Torres Strait and Aboriginal people are becoming population that is a victim of increasing remoteness, on average, and Indigenous Australians are towards more poor health outcomes as compared to other Australians. (Australian Institute of Health and Welfare, 2018). It is important to note that there is a greater rate of death in remote and regional areas as compared to major cities, in regional areas the death rate is 1.05-1.15 times as compared to remote areas where the ratio is 1.2-1.7. It asserts a three times greater rate of death in regional people. People who live in rural areas generally have poorer health than the major city counterparts reflected in their higher levels of diseases, mortality and health risk factors.
Determinant and outcome
There are several factors that contribute to the analysis of facts and figures paving the way for economic barriers, inferring that it leads to increased death rate, ratio of disease and a high mortality rate. It is asserted that there are certain variables that reflect the interventions required for the analysis of rural health status. These determinants are termed as geographical location, socio economic characteristics, rural lifestyle and race. (Healthstats.nsw.gov.au, 2019).
Geographical Location and rural environments
Rural environment and geographical location play a major role in having an influence on the health status of rural population. It is affirmative that the burden of zoonosis is at its peak in rural area, especially in the subject of agricultural employees. In New Zealand, the access to have safe drinking water is sometimes poor in communities where people belonging to Maori are overrepresented or termed as representations. There is a high rate of infectious diseases in Australia taking into account Aboriginal people having substandard supply of water resources, sanitation and washing facilities. It is important to note the characteristics of rural population referring to compound problems that originate from more social causes and fundamental structure. It would not be wrong to say that extensive geographical boundaries are facing major issues regarding healthcare because services are dispersed as low-density because of a greater distance to approach these services and limited chances of having a positive outcome. It is more significant to note that the major determinant of access to services refers to both preventive care and ill health treatment. Travelling to long distance in order to approach health centres have incorporated a restricted diagnosed capacity with large number of delayed treatments. There are incomplete strategical capabilities related to health in rural areas. Adverse health outcomes are also accompanied by a low level of screening and a delayed diagnosis of major health concerns due to poor access to health care services. (Phillips, 2009, pp.2-9).
Rural Lifestyle
Rural Lifestyle is still termed as one of the major determinants of remote health taking into account that rural-urban differences in the incidence of disease and illness are more towards the outcome of occupational hazards. In a simplified form, it refers to personal behaviour rather than rurality. Rural industries are posing a major threat to people because there is increased exposure to certain chemicals that can act as a precursor of biological, mechanical, physical and chemical hazards. There is a massive death rate associated with fisheries and forestry, adhering to the fact that occupational hazards are one of the core reflectors of death rates and disasters. The most prevalent factors of death rate are mining and agriculture in Australia, New Zealand and the US. Lifestyle has a direct impact on the patterns of health behaviour and health literacy, acting as one of the characteristics of remote communities. Rural population and remote communities are a major precursor of the increasing health patterns, there is a great incidence of less healthy behaviours as compared to urban areas. There is a low level of physical activity, unhealthy nutrition, elevated rate of smoking and a high ratio of alcohol consumption. Moreover, the status of socioeconomic disadvantages reflects psychological stress and a threat to better lifestyle. Rural people are more towards preventive screening measures, water safety and exercise regularity. The increasing stance of risk-taking is reflected in the adverse health outcomes in compliance with certain conditions specifically injuries. The relationship between poor health and high rate of risks is inferred by the analysis of health effecting behaviour. It refers to the relationship between people such as individual families, communities and organisms. Although the rural population is more towards being self-sufficient taking into account that they are more supportive towards each other, there is a lack of confidentiality and anonymity habits in the rural dwellers. There are certain psychological factors as well that are playing a major role in the analysis of determination of life style such as sociodemographic factors behaviours, and lifestyle. (Healthstats.nsw.gov.au, 2019).
Socioeconomic characteristics
Australian studies have revealed that there is a great variation in the health status that could show the variation in health status as explained by socioeconomic factors. There are high incidences of heart disease, diabetes, obesity and low birth weight, accompanied by cancer of different body organs. Evidence has revealed that rurality contributes to the health indicators in a number of ways taking into account that socioeconomic factors are not consistent. Studies have reflected that there is a little or average variation in the health status for a particular disease and control of variable in terms of that disease. Other studies have found that socioeconomic deprivation is more strongly associated with economic paradigms other than the conditions after the control of variables. (Phillips, 2009, pp.2-9).
Race and Ethnicity
Torres Straits Islanders, Canadian Aboriginal people and many Alaskan Native populations are catering to the burden of diseases as compared to the non-indigenous people. In Australian indigenous people, death rate is three times higher as compared to other people, parallel to life expectancy that is considerably short. There is a great ratio of cervical cancer death in Australia, taking into account the indigenous component of population. Side by side, there is a high rate of notification regarding chlamydia, syphilis and salmonella in many regions. Indigenous Australian are at a great threat to get coronary heart disease , research reflecting double rate of such records as compared to non-indigenous populations. The poor health differentials reflect a higher proportion of indigenous people in certain areas. The socioeconomic disadvantages faced by people makes them a great threat to a high level of environmental and behavioural risks, as compounded by significant problems that are associated with long distance to services and inability to afford, accompanied by lack of transport and culturally appropriate services. (Healthstats.nsw.gov.au, 2019).
Policy responses
The understanding of health determinants plays a major role in determining the stance of government efforts in order to cater to the issues. Rural health policies are developed in the countries that are predicted on a belief that the status of health is worse in rural areas as compared to urban areas, asserting a perception that rurality is to some extent responsible for worst healthcare outcomes. The policy status and outcomes infer a wide range of interrelated household, health system, community and other policy related determinants that are operating at a variety and number of scales. There are both micro and macro services that are acting out in order to address this issue. The government treated determinants are operating at a number of scales in order to stabilise the stance of poverty and address health needs. It is important to note that policies have a focus asserting solely on the area-based explanations and responses to the health problems that run the risk of diverting attention from the structural and social processes to the misdirecting policy formulation and remedial efforts. It refers to the fact that concentrating on distance and the issues rural population is facing regarding access to health care centres without reflecting poverty, inequalities of resources, discrimination and inequality of allocation of resources must result in sub-operational interventions. Policies have responded in accordance with the expected outcomes, taking into account the concurrent actions to improve employment opportunities, provision of education and physical infrastructure.
It is also equally assertive that none of the policy response is truly effective if it is failed in addressing the factors that contribute to socioeconomic disadvantages and marginalization of Indigenous people. It is despairing to note that certain interventions are incorporated to improve the health status but is it not an always case that the interventions are directed and ultimately achieved the required objectives. In a nutshell, health policies can only be considered responsive if there is a stance of specifically designed programs, having the potential to influence rural health literacy and health-seeking behaviour ensuring availability of required services. (Healthstats.nsw.gov.au, 2019).
Spatial Differences
Spatial differences are presented at different levels reflecting certain boundaries such as political boundaries i.e. local government and local council, services and funding boundaries such as health districts and the administrative boundaries such as ABS boundaries. In accordance with the spatial inequality it is asserted that inadequate health services are more potent in Aboriginal and Torres Strait Islander population. The major population is localized in Eastern Australia located in far north Queensland and in the Central New South Wales. The same stance of remoteness is observed in the central and western states of Australia with a major section of people remote in terms of health, belonging to Northern Territory and Western Australia. The areas with the densest population are locked with few major cities as well. More than 140,000 Aboriginal and Torres Strait Islanders people are living in the areas covered with ISPHCS locations. (Torrens University, 2019).
Drivers and impacts
There are certain facts that act as drivers of spatial differences in the distribution of healthcare facilities in rural areas.
Rural-Urban imbalance of population
Population is one of the greatest factors that play a major role in the equal or acceptable distribution of resources. It is significant to note that in term of Australian health, urban side has always been highlighted taking into account the dire need of resources that can fulfil health needs. It is significant to note that urban population formulates the major section of Australian population and it paves the way for the analysis of the services, asserting urban population as more needy. Although apparent efforts are made to cater to health needs still there is less attention towards coherence to such facilities. Rural-urban imbalance has been taken as one of the impacts as well because when no attention is given as a result of imbalance, there is a greater approach towards the provision of resources in the areas where there is already present services. (Aihw.gov.au, 2019).
Imbalance of resources
Imbalance of resources is also termed as one of the greatest drivers of spatial differences. It is asserted that there are a greater number of resources in urban areas so efforts are imparted to improve such localities. It is significant to note that it includes both natural and artificial resources. In rural areas, there is lack of resources such as roads, pathways and educated population so there is a dire need of efforts that could address the approaching and increasing needs of people. It also highlights that some of the areas are a victim to remote health facilities because there is lack of attention to impart novelty of actions in terms of innovation health centres because of other devastating factors that highlight and hamper the stance of equality. Lack of educated people, lack of medical baseline automatically paves the way for ignorance where people are treated with massive negligence. In accordance with Aboriginal people, it is highlighted that migrated people prefer to stay at areas where there is less population and demographics become a major tool to create disparities. (Torrens University, 2019).
Natural amenities
It is important to note that natural amenities play an equally important role in the analysis of spatial differences in terms of health needs. It is significant to note that most of the urban areas face natural disasters now and then. Such disasters not only hamper the stance of attention that is given to that area, in fact, there is a massive destruction. Considering Queensland, it is quite evident that there is a large amount of natural disasters that affect the efforts made by government. It is more important to note that such disasters not only deteriorate the overall occurring in the country but there is a great deal of negligence in terms of catering to the cause of natural resources. In a simplified form natural disasters not only ensure the rate of destruction but there is greater heed towards the facts and figures that are increasing in terms of death rate and mortality rate. (Torrens University, 2019).
Lack of adherence
One of the major drivers of spatial differences is the lack of adherence, whenever attempts are made to incorporate the features of mitigation of spatial differences. It is significant to note that lack of adherence refers to a number of other factors that can play a crucial role in the determination of basic needs. It is asserted that lack of adherence refers to the framework of competences that are imparted by certain authorities and lawmaking bodies because not all the incorporated policies reach their aims. Although apparently, there seems to be a crucial stance of bringing the paradigms of public and political interest in synchronization, still there is a gap in the long run. Not all the policies that are formulated abide by the stance of achievement. Taking into account the current scenario of rural areas, there is a major gap in the assumptions and the actual implication. Several policies are enforced but there is hardly any stance of applicability because there is a sheer loss of resources and efforts that can fulfil the required goals. (Smith, et, al. 2008 pp.56-66).
Socioeconomic groups
One of the drivers of spatial differences in the socioeconomic groups, highlighting reforms are always brought in the localities with greater economic and high-class strata. There is less heed towards the analysis of the features that can incorporate equality and equity. Usually, major cities are localized by the people with high class who have an approach to all the necessities of life, any action from their side can bring about required results. (Smith, et, al. 2008 pp.56-66).
Future Interventions
There are several strategies and interventions that can deal with the stance of remote rural health such as, Australian Government Indigenous Australian Health Programme, National Aboriginal and Torres Strait Islander Health Plan and Aboriginal and Torres Strait Islander Health Performance framework. These are certain policies that are trying to comprehend to deal with the subject issue. It is important to note that there are several other strategies that can be used to address present gaps such as NGOs and Public Agencies. (Torrens University, 2019).
Discussion on Indicators
The analysis of spatial differences has been incorporated by the implication of National Key Performance Indicator (nKPI). This data has brought into insight that there are 40 areas where 0 of the Torres Strait Islander and Aboriginal people live within a locality that is at a distance of 1 hour to the nearest healthcare area. 11 of the 40 areas have population of more than 600 people. An examination of Grade Point average has inferred that there are 17 primary healthcare services that were not the part of nKPI data collections such as states funded services and other new policy oriented services. It is asserted that 226 of 323 ISPHCS locations are operated by the incorporation of OSR services that are offering all types of health services. The data inferred that Queensland is one of the major areas with the greatest number of service gaps with remote health services in 19 out of 40 areas. Western Australia has remote health in the rural areas of Southern Australia, with 12 areas with service gaps. New South Wales has 5 areas with services gap. Other indicators are population, economic and social characteristics, mortality, morality, and lifestyle and health expectancy. A comparison of indigenous mortality has brought into insight that there is a more stance of migration of people from remote centres to the larger centres in order to cater to the necessities and bring an upheaval in living standards.
In local areas, the mortality rate is much higher, taking into account the interference of socioeconomic factors such as ethnicity, barriers in economic threshold and poor availability of service along with a greater risk of personal risk and hazardous environment. It is significant to note that there is a greater threat towards diseases such as cancer, certain injuries dental health and a greater ratio of mental health in accordance with the fact that mental distortion paves the way for disability. (Australian Institute of Health and Welfare, 2018). Moreover, lack of resources is one of the greater precursors of future disease patterns under the influence of drought, extreme temperature and bushfire. It is also important to note that contact with other disease organisms can also become a potential threat, leading to the analysis of economic rate a tool for the balanced state. (Aihw.gov.au, 2019).
Work Cited
Aihw.gov.au. (2019). online Available at HYPERLINK https//www.aihw.gov.au/getmedia/a34c79a2-be4f-402a-b7c6-cf758974f8ff/18900.pdf.aspxinlinetrue https//www.aihw.gov.au/getmedia/a34c79a2-be4f-402a-b7c6-cf758974f8ff/18900.pdf.aspxinlinetrue
Australian Institute of Health and Welfare. (2016).Australias health 2016, Chapter 6 Preventing and treating ill health - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/chapter-6-preventing-and-treating-ill-health
Australian Institute of Health and Welfare. (2016).Australias health 2016, Chapter 6 Preventing and treating ill health - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/australias-health/australias-health-2016
Australian Institute of Health and Welfare. (2016).Australias health 2016in brief, Australias health as 100 people - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/australias-health/australias-health-2016-in-brief/contents/australias-health-as-100-people
Australian Institute of Health and Welfare. (2018).Annual report 201718, Appendix 2 Products, journal articles and presentations - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/corporate-publications/aihw-annual-report-2017-18/contents/appendix-2-products-journal-articles-and-presentations
Australian Institute of Health and Welfare. (2018).Australias health 2018 in brief, About - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/australias-health/australias-health-2018-in-brief/contents.
Australian Institute of Health and Welfare. (2018).The incidence of insulin-treated diabetes in Australia, Statistical notes - Australian Institute of Health and Welfare. online Available at HYPERLINK https//www.aihw.gov.au/reports/diabetes/incidence-insulin-treated-diabetes-australia-2016/statistical-notes https//www.aihw.gov.au/reports/diabetes/incidence-insulin-treated-diabetes-australia-2016/statistical-notes
Australian Institute of Health and Welfare. (2018).The incidence of remote areas in Australia, Statistical notes - Australian Institute of Health and Welfare. online Available at https//www.aihw.gov.au/reports/diabetes/incidence-insulin-treated-diabetes-australia-2016/statistical-notes
Healthstats.nsw.gov.au. (2019).HealthStats NSW Low birth weight by remoteness from service centres, trends. online Available at HYPERLINK http//www.healthstats.nsw.gov.au/Indicator/mab_lbw/mab_lbw_aria_trend http//www.healthstats.nsw.gov.au/Indicator/mab_lbw/mab_lbw_aria_trend
Healthstats.nsw.gov.au. (2019).HealthStats NSW Place of birth by remoteness from service centres, trends. online Available at http//www.healthstats.nsw.gov.au/Indicator/mab_placebth_cat/mab_placebth_cat_aria_trend
Phillips, A., 2009. Health status differentials across rural and remote Australia.Australian Journal of Rural Health,17(1), pp.2-9.
Smith, K.B., Humphreys, J.S. and Wilson, M.G., 2008. Addressing the health disadvantage of rural populations how does epidemiological evidence inform rural health policies and research.Australian Journal of Rural Health,16(2), pp.56-66.
Torrens University. (2019). online Available at http//phidu.torrens.edu.au/notes-on-the-data/atsi-notes/aboriginal-pop-5yr-age-male-urp
Torrens University. (2019). online Available at http//phidu.torrens.edu.au/notes-on-the-data/demographic-social/aboriginal-pop-5yr-broadage
Torrens University. (2019). online Available at http//phidu.torrens.edu.au/help-and-information/about-our-data/geographical-structures/pha-list
Torrens University. (2019).Topics, Indicators and Notes on the Data. online Available at http//phidu.torrens.edu.au/social-health-atlases/indicators-and-notes-on-the-data/26-social-health-atlases-of-australia-contents/demographic-social/218-aboriginal-total-urp
Health in rural and remote areas PAGE 11
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